HomeMy WebLinkAbout1596 ~
~
neclaration ot Domiclla and Citizenship
TO THE STATE AND COUNTY TAX ASSESSOR,
• e. ~ r
57. LUCIE COUNtY, F~ORIDA:
This is my declaration of [7omicile and Citizenship in the State of Fforida that ~ am filing this day in ecc~rdance and
in conformity with Chapter 222, Section 222.17, Florida Statutes.
I was formerly a legal resident of _.__L1tC~l~~~Zd 1Zjj~n~,_
(City) (State) - ~ -
and 1 residcd at 904 W. Ut110I1 However I have changed my domi~ile
(Street and Number)
to arrd am and have been a bona fide resident of the State of Florida sinca 28th day of
---~unc 19~~ and I reside at __~~Q~_Q~ DrivC
(Street and Number}
i~ORT PtERCE, SAtNT tttC1E COUNTY, FLORIDA
and this statement is to be taken as my declaration of citizensh;p, actual legal residence and domicile in the State of Florida.
(I~sert here any pertinent facts, s~ch as sale of praperty ar business, or relinquishment of employmrnt
at former domicile, removal of family to new domi~ile, purchase of home, etc.)
bntering child in achool
CpR~ ~pK
t;,~„~~i;;~r,, . ~ILED r4~ p~~~~.~r~'a . ~ RE
. ; ~ 14aE~
e „~t E1~~----- ---3004t ~ ~!?OOK
'•a''• y~. ,A~'~ • ~
:
i ~ : JI`i~ ~r e .n !'i ~"M l~ • ,1 f~
=~t c: r~.-'_65 2?~~\'~M`t-~t . 57 '6S I'.? Z7 Q~+j (r~; 57
: C!~ ~ ~ , , r•t• 7'R-`1'+ r,`J C'j\{, ! ~ ~°!°_~.oy
L
- ` UV . •t-~'''`t i1~ R~Gt-, f - (
. • . • . ~ RGG~~; ~ ~ : , ~,.~S, ;;~ER'r(
5T. L~l~ ~'~~pP ST. L'~~l~ COU~'J7Y,
. . F~QKt F~ORI
, DA
I FURTHER CERTiFY that I will comply with al! other requirements of a lega) resident of this State.
I fURTWER CERTIFY that I have no intention to re+urn to my farmer domiCile, and 1 intend to remain in FOR7
PIERCE, SAINT IUCIE CQUNTY, FLORIbA, permanently. ~
~ 'S__- ~
. ~ _
' ~ f _ ~
~ . . (Name)
' Jar~ice Dearduff
' LY
• _ , r~
! , _ i r-;' . _ _ _ -
4 ~ • i ' '4`~ . (Address)
- . t
_ . ,
Swo~n to and subscribc-t! before me this 2~th day of _ AUgu~'t , ~q~ 65
ROGER POITRAS
C K CIRCUIT C URT ~ Notary public
ctsc.fc.l.t~
~Y D.C. My Commission expires
(To be sx~cutsd in duplicate anci original filsd witt~ Clertc Circuit Caurf, and ~1uplicats with Tsx Assessor.)
~ BUGi{1t: J